{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:56:47Z","timestamp":1774436207148,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,28]],"date-time":"2023-01-28T00:00:00Z","timestamp":1674864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Extended maxillectomies with orbital exenteration and facial soft tissue resection need careful planning to achieve satisfactory functional and esthetic outcomes. Only a few solutions provide enough hard and soft tissue on a single pedicle, and only some reconstructive goals might be achievable with a single flap. This paper describes an original inset of the gracilis muscle free flap, used in a vessels depleted patient to salvage a partially failed multi\u2010flap reconstruction after an extensive maxillectomy. A 55\u2010years old man underwent a surgical intervention for a fibrosarcoma of the right maxilla. Due to the disease extension, the resection included right maxilla and palate, the overlying facial soft tissues (including the paranasal, cheek, and infraorbital regions), and the entire orbital content (orbital exenteration). A double flap reconstruction\u2014a free fibula flap and a deep circumflex iliac artery flap\u2014was carried out primarily. However, an intraoperative complication caused a partial flap loss, resulting in a complex tridimensional defect of the orbit and the oral cavity. Therefore, a 18\u2009cm long gracilis muscle free flap was used to fill the defect and save the remaining bony reconstruction. The muscle was inset behind the transplanted bone to seal both the orbit and the oral cavity. No complications occurred after the salvage surgery, with a stable result at the 6\u2010months follow\u2010up. The designed gracilis muscle free flap proved a reliable option for this salvage surgery. However, it could be helpful also in the primary reconstruction of extended maxillectomies in combination with another composite free flap.<\/jats:p>","DOI":"10.1002\/micr.31016","type":"journal-article","created":{"date-parts":[[2023,1,29]],"date-time":"2023-01-29T07:38:10Z","timestamp":1674977890000},"page":"281-285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sequential chimeric fibula\u2010gracilis flap to salvage a complex orbitomaxillary defect: A case report"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4363-388X","authenticated-orcid":false,"given":"Davide","family":"De Cicco","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatological Sciences University of Naples \u201cFederico II\u201d  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4116-6264","authenticated-orcid":false,"given":"Gian Battista","family":"Bottini","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery Paracelsus Medical University Salzburg  Salzburg Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Gaggl","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery Paracelsus Medical University Salzburg  Salzburg Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adoms.2022.100297"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(200001)22:1<17::AID-HED4>3.0.CO;2-2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70113-3"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-004-5173-6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24150"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199709001-00022"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181904b95"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2013.08.018"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22339"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20490"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.52547\/wjps.10.2.33"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26559"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003430"},{"key":"e_1_2_8_15_1","volume-title":"Atlas of regional and free flaps for head and neck reconstruction: Flap harvest and insetting","author":"Urken M. 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